How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $489.78 | Professional | None | $213.80 | $338.84 | $489.78 |
BCBS Kansas Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
BCBS Kansas Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $407.38 | Professional | None | $275.42 | $275.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $436.52 | Facility | None | $323.59 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $602.56 | Professional | None | $234.42 | $354.81 | $602.56 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $457.09 Typical High $12,022.64 | Facility | None | $162.18 | $457.09 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $741.31 Typical High $2,187.76 | Professional | None | $331.13 | $741.31 | $2,187.76 |
United Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $1,778.28 | Facility | None | $125.89 | $407.38 | $1,778.28 |
United Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $524.81 | Professional | None | $239.88 | $338.84 | $524.81 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | 52 · Reduced service | $107.15 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $97.72 | Professional | 53 · Discontinued | $42.66 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $257.04 Typical High $371.54 | Professional | 54 · Surgery only | $158.49 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $31.62 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $21.38 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $239.88 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $147.91 | $239.88 | $346.74 |
Where Kansas sits
The same service costs 3.7 times more in Wisconsin than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 18th of 51
$398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.